Individual provider Active NPI

Thanh T Nguyen, O.D.

  • Optometrist
  • San Diego, CA
National Provider Identifier
1992813323
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT 13126 Issued in CA
Practice address
12650 Sabre Springs Pkwy, #203
San Diego, CA 92128-4114
Phone
(858) 748-1265
NPI assigned
Aug 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT 13126 CA Primary

Addresses

Primary practice location

12650 Sabre Springs Pkwy, #203
San Diego, CA 92128-4114

Mailing address

12650 Sabre Springs Pkwy, #203
San Diego, CA 92128-4114
Phone (858) 748-1265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090109000316 CA Practitioner - Optometry 7315000817 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13126CAMDMarriage & Family Therapist
OPT 13126CAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eyesmith, a Professional Optometry Corporation Optometrist CurrentSince Mar 24, 2024 Accepting new patients
Jasmine P. Nguyen, O.D., Inc. CurrentSince May 5, 2019 Accepting new patients
Tran Ta Inc Optometrist Past Accepting new patients

Locations

4029 43rd St
Ste 300
San Diego, CA 92105
Phone (619) 284-3937

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1992813323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12650 SABRE SPRINGS PKWY, #203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284114",
            "telephone_number": "858-748-1265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12650 SABRE SPRINGS PKWY, #203",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921284114",
            "telephone_number": "858-748-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THANH",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT 13126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.